title: The association of very-low-density lipoprotein with ankle-brachial index in peritoneal dialysis patients with controlled serum low-density lipoprotein cholesterol level.
abstract: BACKGROUND
  Peripheral artery disease (PAD) represents atherosclerotic disease and is a risk factor for death in peritoneal dialysis (PD) patients, who tend to show an atherogenic lipid profile. In this study, we investigated the relationship between lipid profile and ankle-brachial index (ABI) as an index of atherosclerosis in PD patients with controlled serum low-density lipoprotein (LDL) cholesterol level.
  
  
  METHODS
  Thirty-five PD patients, whose serum LDL cholesterol level was controlled at less than 120 mg/dl, were enrolled in this cross-sectional study in Japan. The proportions of cholesterol level to total cholesterol level (cholesterol proportion) in 20 lipoprotein fractions and the mean size of lipoprotein particles were measured using an improved method, namely, high-performance gel permeation chromatography. Multivariate linear regression analysis was adjusted for diabetes mellitus and cardiovascular and/or cerebrovascular diseases.
  
  
  RESULTS
  The mean (standard deviation) age was 61.6 (10.5) years; PD vintage, 38.5 (28.1) months; ABI, 1.07 (0.22). A low ABI (0.9 or lower) was observed in 7 patients (low-ABI group). The low-ABI group showed significantly higher cholesterol proportions in the chylomicron fraction and large very-low-density lipoproteins (VLDLs) (Fractions 3-5) than the high-ABI group (ABI>0.9). Adjusted multivariate linear regression analysis showed that ABI was negatively associated with serum VLDL cholesterol level (parameter estimate=-0.00566, p=0.0074); the cholesterol proportions in large VLDLs (Fraction 4, parameter estimate=-3.82, p=0.038; Fraction 5, parameter estimate=-3.62, p=0.0039) and medium VLDL (Fraction 6, parameter estimate=-3.25, p=0.014); and the size of VLDL particles (parameter estimate=-0.0352, p=0.032).
  
  
  CONCLUSIONS
  This study showed that the characteristics of VLDL particles were associated with ABI among PD patients. Lowering serum VLDL level may be an effective therapy against atherosclerosis in PD patients after the control of serum LDL cholesterol level.
authors.affiliation: Department of Nephrology, Tokyo Kyosai Hospital, Nakameguro 2-3-8, Meguroku, Tokyo 153-8934, Japan. tokyo.kyosai.kanda@gmail.com.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Kanda
authors.forename: Masumi
authors.initials: M
authors.lastname: Ai
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Okazaki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Maeda
authors.forename: Sei
authors.initials: S
authors.lastname: Sasaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000209:etiology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008079:Lipoproteins, VLDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL